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Office of Public and Intergovernmental Affairs

Remarks by Secretary Eric K. Shinseki

National Association State Departments of Veterans Affairs (NASDVA)
Mid-Winter Conference
Alexandria, Virginia
February 13, 2013

Good morning, everybody. Jim [Willis, NASDVA President], thanks for that kind introduction and for your leadership of the association.

I also want to recognize Paul Galanti and Tom Moe, two men who served our country well under the most difficult circumstances, and were released from captivity as prisoners of war forty years ago today. Paul and Tom, welcome home.

Let me also acknowledge NASDVA's Vice Presidents Clyde Marsh and Lonnie Wangen, your Secretary Tom Palladino. Also VA Under Secretaries Allison Hickey and Steve Muro, and Dr. Bob Jesse, our Principal Deputy Under Secretary for Health, and the rest of the VA team.

It's good to gather with all of you again. I'm honored to be here today, and as I've said before, we never do this enough.

It's been four years, but it remains that rare privilege of being able to give back to those Veterans of World War II and Korea, on whose shoulders I stood as I grew up in the profession of arms; those with whom I went to war in Vietnam; and those youngsters I sent to war as Army Chief of Staff.

Four years ago, President Obama asked me to make things better for Veterans quickly and put into place those changes that could continue making things better for them for out to 25 years. These two goals do not have the same aim points. Change is hard. Change in large organizations is near impossible. Three hundred and twenty-four thousand good people come to work every day at VA facilities all across this country. And change is impossible, if you can't present a clear, compelling argument: Why we are changing, what we are changing, and how this will make things better for Veterans? It requires discipline, determination, and money.

Between 2009 and 2014, our budgeted medical obligations increased for:

  • Traumatic brain injury funding by 21 percent;

  • Spinal cord injury programs by 36 percent;

  • Mental health by 45 percent;

  • Readjustment counseling by 49 percent;

  • Long-term care by 50 percent;

  • Prosthetics by 75 percent;

  • Women's Veterans programs by 158 percent;

  • OEF/OIF/OND funding by 161 percent.

Funding programs like these is one thing; making them accessible to Veterans is something entirely different. So in the same period we opened 38 community-based outpatient clinics, for a total of 821 CBOCs today, and increased the numbers of mobile outpatient clinics and mobile Vet Centers, serving rural Veterans, to 70.

Last August, we opened a new, state-of-the-art medical center in Las Vegas, our first in 17 years. We also expect to open another new, state-of-the-art medical facility in Orlando this year. New hospitals are under construction in Denver and New Orleans, and two others, Louisville and Omaha, are in design.

Access means making VA's medical care available to Veterans, no matter where they live. Not just in these urban settings, but in the rural, highly rural, and remote locations, like western Alaska, where roads don't exist. We must not let the tyranny of distance dictate substandard medical care for any Veterans.

So, access must be more than the ability to walk into a VA medical facility. Telehealth and telemedicine are the major breakthroughs in healthcare delivery in 21st century medicine. This year we are investing roughly $335 million in virtual access technologies to connect Veterans, wherever they can enter our system. This is a 368 percent increase since 2009, connecting our 152 medical centers and their 104 affiliated medical schools with our 821 community-based outpatient clinics, our 300 Vet Centers, and our 70 mobile clinics—over 1,300 VA points of care.

We have signed a memorandum of agreement with the Indian Health Service and are working with DOD to expand the number of locations where we can partner on behalf of the serving military and our Veterans, especially our Native American Veterans. Our devotion to Veterans must at least equal their devotion to this Nation and to one another.

Four years ago, VA established three key priorities to get things moving quickly: increasing Veterans' access to care and benefits; eliminating the claims backlog in 2015; and ending Veteran homelessness, also in 2015.

Since 2009, we've added over 800,000 Veterans to our healthcare rolls. Access! We will continue and expand our outreach to enroll veterans in VA. We've also opened six new cemeteries and two annexes in the last four years. Five more cemeteries are planned over the next five years. We have a plan to provide burial services at locations where there are no VA, state, or tribal veterans cemeteries available. Through an innovative partnership with existing public and private cemeteries, our rural initiative will allow us to open eight national Veterans burial grounds that meet the standards of our existing 131 national shrines. All of this is much needed and long overdue. Again, access!

To be direct, there is little use in talking about access unless we can process Veterans' compensation claims better and faster than we do today. Our goal is to process claims in less than 125 days at 98 percent accuracy, and to end this thing called the claims backlog.

We are not there yet, even though we are processing a million claims each year—3.9 million claims in the past four years—unprecedented numbers. But incoming claims continue to outpace the number of outgoing decisions. We must automate and get out of paper, and we are in the process of doing just that.

Today, we are fielding the automated tool that we have been developing for the past two years, VBMS, the Veterans Benefits Management System. VBMS has already been deployed to 18 VBA regional offices and will be fielded to all 56 regional offices by the end of this year. That will give us at least two years to take down the backlog in 2015. The faster we field VBMS, the more time we will have to eliminate the backlog. We are after it.

Now the last of our three promises, ending Veterans' homelessness. We have reduced the estimated number of homeless Veterans living on our streets by nearly 17 percent since 2009—estimated today at 62,600. In addition to this rescue effort, we are building a national homeless Veterans registry that will allow us to see the population more clearly and insure that we are focusing resources for best results.

The two arms of this war on homelessness are rescue and prevention—rescue those who are on the streets today, and prevent those at risk of homelessness from starting that downward spiral. Calls to our National Call Center for Homeless Veterans are up 123 percent in the last fiscal year, and our referrals to VA services are up 132 percent.

We're working closely with 150 community partners in our prevention strategy. In 2011, we awarded $60 million in supportive service grants to assist Veterans and families facing the prospect of life on the streets. In 2012, we increased those grants to $100 million, and for 2013, we are reviewing proposals for the $300 million in grants we will be distributing later this year. Those resources directly helped about 21,000 Veterans and over 35,000 household members, including nearly 9,000 children. This year's grants will help up to 70,000 Veterans and family members avoid homelessness.

We have to play offense and defense at the same time—rescue the homeless from our streets and prevent a largely invisible "at-risk" population from ending up there. Nothing magical here—warm handoffs from DOD through a good Transition Assistance Program, successful completion of education and training programs, jobs, and medical treatment for those with issues that come with military service.

Since 2009, VA has paid over $25 billion in Post-9/11 GI Bill benefits to more than 893,000 Service members, Veterans, family members, and survivors. We are now working with Student Veterans of America to track graduation rates.

I usually have a one-word speech for any of the student audiences I address: Graduate. That's it: "Graduate. If I sound like your dad, I am. I'm paying most of your bills. There is no payoff to you, to this program, or to our country, if you don't graduate. So, graduate!"

For some Veterans, education alone is not enough. We need to help them deal with the baggage they are carrying when they come to us: depression, substance abuse, PTSD, TBI, and other mental health issues. The number of Veterans seeking VA mental healthcare has increased, and we are increasing staffing levels, growing telemental health capabilities, and employing state-of-the-art, evidence-based therapies.

We will meet the President's directive to increase our mental health clinical staff by 1,600 by 30 June of this year.We're also hiring and training 800 peer-to-peer mental health specialists, who are Veterans and who have wrestled with the same mental health issues themselves. Credibility and trust are important to service in uniform. Those attributes are equally important to helping bring our comrades all the way home.

We've integrated mental healthcare into the primary care clinics of our medical centers, and many of our larger community-based outpatient clinics in order to expand access and reduce the stigma associated with mental healthcare.

Veteran suicides are a priority. Since its inception in 2007, the Veterans Crisis Line has answered over 725,000 calls and responded to more than 80,000 chats and 5,000 texts from Veterans in distress. Twenty-five thousand men and women have been rescued through our intervention. The number of calls is increasing; the percentage of rescues is going down; the number of Veterans entering treatment is going up; and the Veterans suicide rate has declined slightly. Our suicide profile is the 50-year-old, not the 30-year-old.

We have just completed a 2012 VA Suicide Data Report—our first effort to gain a more comprehensive understanding of Veterans' suicides that can inform our prevention efforts. It bears a close reading. The more we all understand these issues, the better we will be at helping solve it.

Very little of what we do at VA originates in VA. Much of what we work on begins in DOD. So, for the past four years, we've worked at strengthening our VA-DOD partnership. Secretaries Bob Gates and Leon Panetta and I have personally met 12 times in the last two years—three times since December 2012 alone. This is an important relationship for our Veterans, and we will continue working to bring our two large departments closer together.

For example, VA is investing up to $550 million dollars in DOD's Transition Assistance Program to fund departing Servicemembers' exit physicals. Why? Because each departing Servicemember deserves a baseline physical for the rest of their lives. And we need to be able to service-connect any issues, physical or mental, resulting from military service before the uniforms come off. Documenting their needs is the first, critical step in providing them the care and benefits they have earned. We all need to assure that transitions, to include exit physicals, go well.

VA's transformation is a work in progress. We've accomplished a lot over the last four years, thanks to our dedicated workforce. But much more remains to be accomplished for Veterans.

There much more to discuss, more to tell you about what VA has accomplished, and what we have ahead of us to achieve. My colleagues are here to do that, so I will wrap up this morning simply by thanking NASDVA for your partnership, your counsel, and your close cooperation and successes in caring for America's Veterans.

My efforts, and those of my 324,000 colleagues, will continue full bore as we work to do the right thing by America's Veterans. We will realize President Obama's vision, and the American people's vision, of a 21st century VA, worthy of those who, by their service and sacrifice, have kept our Nation free. Thank you.